One Minute Preceptor

--WHAT?—

Get a commitment.  After presenting the facts of a case to you, the learner may stop to wait for your response.  Ask them to state what he or she thinks about the issues presented by the data. 

Examples:  “What do you think is going on with the patient?” “How can you tie this all together?”

 --WHY?--

Probe for supporting evidence.  After committing him/herself on the presenting problem, the learner may look to you to confirm or refute the opinion.  Before doing that, ask the learner for evidence (why) that he or she feels supports the opinion.

Examples:  “I am interested in how you came to that diagnosis.”  “What were the major findings that led to your conclusion?”  “What else did you consider regarding the patient’s abdominal pain?” 

--WHENEVER…--

Teach general rules
At this point, provide general rules, concepts, or considerations targeted to the learner’s level of understanding.

Example:  “Patients with cystitis usually have pain with urination, frequency, urgency, and a UA that shows white blood cells and bacteria.  However, (whenever) you see fever, flank pain, nausea, and vomiting would be unusual and this indicates the presence of pyelonephritis.”

--FEEDBACK!--

Reinforce what was done right.  Focus on the specific deed and the effect it had.  (Give feedback)

Example:  “You considered the cost of the medication and schedule of dosing in your selection of an antihypertensive.  Your sensitivity to this will contribute to improving this patient’s compliance.”                       

Correct mistakes

Example:  “You may be right to attribute the patient’s altered mental status to hepatic encephalopathy.  However, given the recent history of a fall and coagulopathy, a head CT should have been done to rule out bleed or subdural hematoma.”  

Reference:  Neber, J.O., Gordon, K.C., Meyer, B., and Stevens, N. “A Five Step “Microskills” Model of Clinical Teaching”.  J Am Board Family Practice 5:419-424, 1992.

Updated: 12/20/06